ChenMed LLC
We’re unique. You should be, too.
We’re changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?
We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team.
Overview
The Lead, Provider Enrollment Coordinator is responsible for managing/overseeing ChenMed’s third-party provider enrollment partner to ensure accurate and timely provider enrollment submissions for new providers with market payors, as well as ensuring that recredentialing is processed promptly. The role includes assessing and providing continuous improvement recommendations to the provider enrollment process, co-facilitating improvement design sessions with Talent Acquisition, HR Services and Systems, Network and Operations, and training respective departments on processes and guidelines. The incumbent serves as the primary point of contact for resolving market questions and issues related to providers\' credential status. Essential job duties / responsibilities
Leads weekly calls with provider enrollment third-party partner to ensure enrollment and recredentialing are processed in a timely fashion. Coordinates and monitors credentialing activities processed by the provider enrollment partner to ensure timely processing of provider payor and facility applications, including supporting the collection of required documents from providers, as needed. Manages the acquisition of professional state licenses through ChenMed’s third-party provider enrollment partner. Conducts monthly payer roster validations to ensure accurate primary practice locations, panel status and directory visibility with health plans and the Provider Enrollment vendor, ensuring alignment. Provides credentialing status updates to markets on new providers. Maintains current credentialing requirements and point of contact with each payor. Supports Credentialing Manager with new market projects. Fields and resolves credentialing related questions and issues from markets. Identifies process improvement opportunities and presents recommendations to Credentialing Manager and other leadership stakeholders. Identifies issues that require additional investigation and evaluation, validates discrepancies with provider payor participation statuses and ensures appropriate follow up. Implements improvement opportunities by creating or updating documentation and training resources. Serves as the primary contact to work with Legal, Risk, Compliance and Billing departments to ensure seamless submission of enrollment and recredentialing. Serves as the primary contact for PCP recruiters on providing clinical ready effective dates for incoming providers. Compiles and maintains current and accurate credentials information for all providers using Workday. Obtains provider information for web-based applications and credentialing databases such as PECOS and CAQH during initial new hire/onboarding of clinicians. Obtains professional liability insurance for providers and forwards to the Provider Enrollment vendor. Completes provider applications for expiring provider credentials to maintain active credentials necessary to enroll with payors (DEA, State Licensure, National Board Certification, and CDS as applicable). Knowledge, skills and abilities
Knowledge of Medicare, Medicaid, and Commercial Payer Provider Enrollment rules, regulations and guidelines. Knowledge of credentialing requirements such as NCQA, AAAHC and / or URAC. Knowledge and understanding of the credentialing process. Ability to effectively communicate, both verbally and in writing, with team members, supervisors, providers, clinicians and insurance contacts. Ability to maintain complete confidentiality in handling sensitive enrollment issues. Professional, motivated and pleasant demeanor. Excellent organizational, interpersonal and follow-up skills with attention to detail and accuracy. Informational research skills. Strong problem-solving skills; database management including querying, reporting, and document generation. Ability to organize and prioritize work and manage multiple priorities to meet deadlines. Ability to work independently with minimal supervision. Ability to establish and maintain effective working relationships with external vendors/contacts and internal stakeholders including providers, management, staff. Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus other related software. Ability and willingness to travel locally, regionally and nationwide up to 10% of the time. Spoken and written fluency in English. Education and experience criteria
BA/BS degree in Healthcare Administration, Business Administration or a related field OR additional experience above the minimum will be considered in lieu of the required education on a year-for-year basis. A minimum of 5 years work experience as a Credentialing/Physician Enrollment Coordinator or a similar role is required. A minimum of 1 year of Medical/Payor Credentialing and/or hospital privileging experience is required. About ChenMed
We’re ChenMed and we’re transforming healthcare for seniors and changing America’s healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care. ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people’s lives every single day. Current employee apply here. Current contingent worker please see job aid here to apply
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The Lead, Provider Enrollment Coordinator is responsible for managing/overseeing ChenMed’s third-party provider enrollment partner to ensure accurate and timely provider enrollment submissions for new providers with market payors, as well as ensuring that recredentialing is processed promptly. The role includes assessing and providing continuous improvement recommendations to the provider enrollment process, co-facilitating improvement design sessions with Talent Acquisition, HR Services and Systems, Network and Operations, and training respective departments on processes and guidelines. The incumbent serves as the primary point of contact for resolving market questions and issues related to providers\' credential status. Essential job duties / responsibilities
Leads weekly calls with provider enrollment third-party partner to ensure enrollment and recredentialing are processed in a timely fashion. Coordinates and monitors credentialing activities processed by the provider enrollment partner to ensure timely processing of provider payor and facility applications, including supporting the collection of required documents from providers, as needed. Manages the acquisition of professional state licenses through ChenMed’s third-party provider enrollment partner. Conducts monthly payer roster validations to ensure accurate primary practice locations, panel status and directory visibility with health plans and the Provider Enrollment vendor, ensuring alignment. Provides credentialing status updates to markets on new providers. Maintains current credentialing requirements and point of contact with each payor. Supports Credentialing Manager with new market projects. Fields and resolves credentialing related questions and issues from markets. Identifies process improvement opportunities and presents recommendations to Credentialing Manager and other leadership stakeholders. Identifies issues that require additional investigation and evaluation, validates discrepancies with provider payor participation statuses and ensures appropriate follow up. Implements improvement opportunities by creating or updating documentation and training resources. Serves as the primary contact to work with Legal, Risk, Compliance and Billing departments to ensure seamless submission of enrollment and recredentialing. Serves as the primary contact for PCP recruiters on providing clinical ready effective dates for incoming providers. Compiles and maintains current and accurate credentials information for all providers using Workday. Obtains provider information for web-based applications and credentialing databases such as PECOS and CAQH during initial new hire/onboarding of clinicians. Obtains professional liability insurance for providers and forwards to the Provider Enrollment vendor. Completes provider applications for expiring provider credentials to maintain active credentials necessary to enroll with payors (DEA, State Licensure, National Board Certification, and CDS as applicable). Knowledge, skills and abilities
Knowledge of Medicare, Medicaid, and Commercial Payer Provider Enrollment rules, regulations and guidelines. Knowledge of credentialing requirements such as NCQA, AAAHC and / or URAC. Knowledge and understanding of the credentialing process. Ability to effectively communicate, both verbally and in writing, with team members, supervisors, providers, clinicians and insurance contacts. Ability to maintain complete confidentiality in handling sensitive enrollment issues. Professional, motivated and pleasant demeanor. Excellent organizational, interpersonal and follow-up skills with attention to detail and accuracy. Informational research skills. Strong problem-solving skills; database management including querying, reporting, and document generation. Ability to organize and prioritize work and manage multiple priorities to meet deadlines. Ability to work independently with minimal supervision. Ability to establish and maintain effective working relationships with external vendors/contacts and internal stakeholders including providers, management, staff. Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus other related software. Ability and willingness to travel locally, regionally and nationwide up to 10% of the time. Spoken and written fluency in English. Education and experience criteria
BA/BS degree in Healthcare Administration, Business Administration or a related field OR additional experience above the minimum will be considered in lieu of the required education on a year-for-year basis. A minimum of 5 years work experience as a Credentialing/Physician Enrollment Coordinator or a similar role is required. A minimum of 1 year of Medical/Payor Credentialing and/or hospital privileging experience is required. About ChenMed
We’re ChenMed and we’re transforming healthcare for seniors and changing America’s healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care. ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people’s lives every single day. Current employee apply here. Current contingent worker please see job aid here to apply
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